Individual
SCOTT MICHAEL ASTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
8854 W EMERALD ST STE 290, BOISE, ID 83704-4846
(208) 296-7500
(208) 296-7501
Mailing address
8854 W EMERALD ST STE 290, BOISE, ID 83704-4846
(208) 296-7500
(208) 296-7501
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
2365
CO
363AM0700X
Medical Physician Assistant
Primary
PA-1370
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1255482683
—
ID
05
—
82377774
—
CO
01
—
P00750757
RR MEDICARE
CO
Enumeration date
01/14/2007
Last updated
11/26/2024
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